Objective To explore the related risk factors between adults with diabetes and cardiovascular disease risk.Methods Five hundred and fifty-seven patients whose age were over 20 years with diabetes mellitus were hospitalized in the First People's Hospital of Shangqiu from Jan.2008 to Dec.2013.According to the major risk factors of cardiovascular risk assessment,Framingham cardiac risk score was use to assess and stratify patients;and then graded as low risk group(＜ 10％),intermediate risk group(10％ to 20％) and the high risk group(＞ 20％).Predicted the next 10 years the probability of the risk of cardiovascular disease.Results Among 557 patients,275 cases were male and 282 cases were female,79 cases (14.18％) were type Ⅰ diabetes mellitus and 478 cases (85.82％) were type Ⅱ diabetes mellitus.Meanwhile,10 years the probability of the risk of cardiovascular disease showed that there were 103 cases of low risk group(18.5％),91 cases of intermediate risk group (16.3％),195 cases of high risk group (30.2％) and 168 cases of cardiovascular disease group who had cardiovascular disease (30.2％).(1) Characteristics of risk factors for cardiovascular disease of risk stratification:①There was high incidence of metabolic syndrome in patients with diabetes mellitus,which was up to 37.9％ even in low risk group and 60.5％ in high risk group.②The average age of high risk group was (63.5 ± 11.7) years old which was higher than the low risk group ((50.3 ± 15.4) years old).③Systolic pressure of high risk group was (143.4 ± 18.1) mmHg,higher than that of the low risk group ((125.7 ± 13.2) mmHg).④It was hard to control the blood pressure in high risk group,so as a few cases(32.3％) were up to the standard.⑤The incidence of chronic kidney disease in high risk group was 21.5％,which was significant higher than that in intermediate risk group(7.7％) and low risk group(7.8％).(2) In high risk groupn,type Ⅱ diabetes mellitus's incidence was 31.6％ which was higher than type Ⅰ diabetes mellitus's(16.4％).(3)In high risk group,the proportion of age range from 70 to 79 years old was up to 39.2％.Conclusion The overall risk of cardiovascular disease increases in patients with type Ⅱ diabetes.Metabolic factors may be the main risk.The risk assessment of diabetic patients will help to increase the intensity of treatment.

Objective To investigate the relationship between plasma fibrinogen levels,aldosterion levels and left ventricular mass in patients with essential hypertension.Methods Two hundred and seventy-three patients with essential hypertension were selected as subjects.Eldow vonous blood sample were taken to measure the rennin,aldosterion,fibrinogen,D-dimer,prothrombin fragment 1 + 2 (F1 + 2),and plasminogen activator inhibitor-1 (PAI-1) concentration by radioimmunoassay.And assessed cardiac structure and function in patients ultrasound heartbeat by application of ultrasound heartbeat.According to fibrinogen levels,all patients were divided to low(A group,n =95),medium (B group,n =87) and highest (C group,n =91) groups,and comparative analyzed the general clinical data,biochemical indexes,ultrasound heartbeat graph test results of the 3 groups.Meanwhile to compare the differences between 3 groups of left ventricular mass index on the two different concentrations of plasma aldosterone average ≥ 125 pmol/L or ＜ 125 pmol/L.Results Left ventricular mass index (LVMI) increased in patients with aldosterone levels ≥ 125 pmol/L as the plasma aldosterone increased significantly.The left ventricular mass index in A,B,C group were (35.0 ± 3.1),(45.0 ± 3.6),(51.0 ± 2.9) g/m2 respectively,the difference between the 3 groups have statistical significance (F =6.65,P ＜ 0.01).Within C group,LVMI in patients with aldosterone concentration(≥ 125 pmol/L) was greater than ＜ 125 pmol/L(t =11.65,P ＜ 0.01).Meanwhile the fibrinogen concentration gradually increased in A,B and C group (2630 (2420-2790),3290 (3170-3430),4210 (3791-4580),respectively).Fibrinogen concentration in C group was higher than that in the other two groups (Z =-2.46,P ＜ 0.01).Ultrasonic heartbeat graph examination Results showed that left ventricular diameter in C group was the biggest than that in A and B groups (A,B,C group were (20.0 ± 2.3),(22.0 ± 3.9),(23.0 ± 3.1) mm/m2 respectively,F =8.16,P ＜ 0.05);The same trends were also seen regarding of interventricular septal thickness (A,B,C group were(9.2 ± 1.9),(10.1 ± 2.0),(10.5 ± 2.4) mm respectively,F =10.52,P ＜ 0.01),left ventricular posterior wall thickness (A,B,C group were (8.8 ± 1.5),(9.2 ± 1.6),(9.7 ± 1.7) mm respectively,F =10.6,P＜0.01) and left ventricular mass(A,B,C group were(37 ±9),(43 ± 11),(45 ± 13) g/m2 respectively,F =11.6,P ＜ 0.01).Conclusion Plasma fibrinogen and aldosterone concentrations are associated with left ventricular mass in patients with essential hypertension.Both them of interaction and participate to left ventricular hypertrophy commonly.

Objective: To observe the effect of ivabradine (IVA) on atrial and ventricular monophasic action potential duration (MAPD) and its proarrhythmic action at presence of sea anemone toxin-II (ATX-II) in isolated rabbit heart modelin vitro. Methods: The perfusion of isolated heart from female New Zealand white rabbit was conducted by Langendorff method in vitro. Left atrial and left ventricular endo- , epi-cardial action potential were recorded when pacing with ifxed frequency of 350 ms (in correspondence with the heart rate of 171 times/min) to observe the effect of IVA alone and ATX-II (3 nmol/L) with IVA on MAPD90. In addition, to observe the action of IVA alone and ATX-II with IVA on proarrhythmia when IVA reducing the heart rate to autonomous cardiac rhythm as (156±10) times/min. Results: IVA at (3-10) μmol/L prolonged atrial and ventricular endo- , epi-cardial MAPD90 by (15.9 ± 2.0) ms, (31.5 ± 4.0) ms and (23.9 ± 3.0) ms (n=6,P<0.01), respectively. ATX-II at 3 nmol/L prolonged atrial and ventricular MAPD90 by (36.5 ± 5.0)ms and (19.9 ± 3.0) ms, (19.5 ± 4.0) ms (n=6,P<0.01) respectively. With ATX-II treatment, IVA at (6-10) μmol/L decreased atrial MAPD90 by (14.4 ± 4.0) ms (n=6,P<0.01), it induced atrial arrhythmia. With 3 nmol/L of ATX-II treated ventricle, IVA at (3-10) μmol/L obviously prolonged endo- and epi-cardial MAPD90 by (36.2 ± 7.0) ms and (27.5 ± 5.0) ms(n=6,P<0.01), respectively. IVA didn’t increase ventricular beat-to-beat variability and transmural dispersion of MAPD90 no matter with or without ATX-II treatment, no ventricular arrhythmia occurred. Conclusion: IVA prolongs both atrial and ventricular MAPD, with increased late sodium current, IVA may induce atrial arrhythmia but not ventricular arrhythmia in experimental rabbits in vitro.

BACKGROUND:Currently,there is a lack of large sample studies to analyze the bone metabolism level of patients with femoral head necrosis of different etiologies and stages,which is not conducive to the development of better necrosis-promoting repair strategies. OBJECTIVE:To study the bone metabolism of patients with osteonecrosis of the femoral head with different etiologies and Association Research Circulation Osseous(ARCO)stages. METHODS:A retrospective study was performed on 401 patients diagnosed with osteonecrosis of the femoral head as the trial group,and 81 healthy subjects as the control group.The trial group could be divided into three groups according to different etiologies:steroid-induced osteonecrosis of the femoral head,alcoholic osteonecrosis of the femoral head and traumatic osteonecrosis of the femoral head,and were divided into stages Ⅱ/Ⅲ/Ⅳ according to different ARCO stages.Seven bone metabolism-related indicators of all subjects were collected,including bone metabolism-regulating hormone 25-hydroxyvitamin D and bone conversion markers:N-terminal propeptide of type Ⅰ procollagen,degradation product of type Ⅰ collagen,n-terminal middle molecular fragment of osteocalcin,general biochemical markers of bone metabolism:serum calcium,serum phosphorus,serum alkaline phosphatase.The bone metabolism levels of each group were compared and the independent factors associated with osteonecrosis of the femoral head were determined by binary Logistic regression analysis. RESULTS AND CONCLUSION:Compared with the control group,levels of degradation product of type Ⅰ collagen,N-terminal propeptide of type Ⅰ procollagen,n-terminal middle molecular fragment of osteocalcin,serum phosphorus and alkaline phosphatase in the trial group were significantly increased(all P＜0.05).Based on the presence or absence of the disease,according to binary Logistic regression analysis,degradation product of type Ⅰ collagen,N-terminal propeptide of type Ⅰ procollagen,and n-terminal middle molecular fragment of osteocalcin were independent factors associated with osteonecrosis of the femoral head.The levels of degradation product of type Ⅰ collagen and N-terminal propeptide of type Ⅰ procollagen in three groups of patients with different etiologies were higher than normal reference values.The bone metabolism-regulating hormone 25-hydroxyvitamin D and serum calcium in the alcoholic osteonecrosis of the femoral head group were higher than those in the other two groups(P＜0.05).The level of bone metabolism-regulating hormone 25-hydroxyvitamin D in steroid-induced and traumatic osteonecrosis of the femoral head groups was lower than the normal value.There were no significant differences in seven bone metabolism-related indicators in patients with ARCO stages Ⅱ,Ⅲ and Ⅳ osteonecrosis of the femoral head(all P＞0.05),but degradation product of type Ⅰ collagen and N-terminal propeptide of type Ⅰ procollagen in these three groups were higher than normal reference values.Bone metabolism-regulating hormone 25-hydroxyvitamin D in patients with ARCO stage Ⅱ and ARCO stage Ⅳ was lower than the normal reference value.It is concluded that the bone metabolism level of osteonecrosis of the femoral head patients was abnormal.The degradation product of type Ⅰ collagen and N-terminal propeptide of type Ⅰ procollagen of osteonecrosis of the femoral head patients with different etiologies and ARCO stages were all higher than the normal reference value,and they were in a state of high bone turnover.Degradation product of type Ⅰ collagen,N-terminal propeptide of type Ⅰ procollagen and n-terminal middle molecular fragment of osteocalcin may be risk factors for the pathogenesis of osteonecrosis of the femoral head.

Objective To investigate the clinical effect of percutaneous hollow screw combined with tension band internal fixation for comminuted patellar fracture after arthroscopic reduction.Methods 105 patients with comminuted patellar fracture in our hospital from April 2013 to September 2017 were selected and divided into observation group (n =53) and control group (n =52) according to different treatment schemes.The control group was treated with conventional open reduction and Kirschner wire combined with tension band internal fixation,while the observation group was treated with arthroscopic assisted reduction and percutaneous cannulated screw combined with wire tension band internal fixation.The operation status and postoperative fracture healing time of the two groups were compared.One-year follow-up was performed after operation.The incidence of complications,the excellent and good rate of operation,and the preoperative and postoperative pain scores (VAS) and knee were compared.Hospital for special surgery knee score (HSS),Activity of Daily Life Scale (ADL),quality of life score (the Mos 36-item Short Form Health Survey,SF-36) were compared.Results The observation group had fewer fluoroscopy times during operation,shorter incision length and shorter healing time after operation than the control group (P ＜ 0.05);the incidence of complications in the observation group was 3.85％,lower than 20.00％ in the control group,and the excellent and good rate of operation was 96.15％,higher than 82.00％ in the control group (P ＜ 0.05);the VAS scores of the two groups were lower than those of the control group one year after operation,and the scores of HSS,ADL and SF-36 were lower than those of the control group.The preoperative improvement was higher in the observation group than in the control group (P ＜ 0.05).Conclusions Arthroscopic reduction combined with percutaneous hollow screw and tension band internal fixation for patellar comminuted fracture can reduce surgical trauma and accelerate the rehabilitation of patients.It can reduce the incidence of complications,relieve pain,improve knee function,daily living ability and quality of life,and the effect is remarkable.

Prostate cancer has become the most common malignant disease in male. Due to development of therapy methods, the overall survive rate of advanced prostate cancer has been improved significantly. The demands for higher quality of life are impending in advanced prostate cancer patient. With the progression of prostate cancer, about 1/3 to 2/3 of patients will suffer from moderate to severe lower urinary tract symptoms. Severe lower urinary tract symptoms can lead to negative effects on treatment and quality of life. However, there is no standard treatment for lower urinary tract symptoms in advanced prostate cancer patients. This article reviews the clinical application of palliative transurethral resection of prostate in patients with advanced prostate cancer.

MED1 is a key transcription co-activator subunit of the Mediator complex that is essential for RNA polymerase II-dependent transcription. MED1 functions as a co-activator for PPARs and other nuclear receptors and transcription factors, and plays an important role in lipid metabolism. To examine how MED1 might affect plasma lipids, plasma triglyceride, cholesterol levels, and lipoprotein profiles, were measured in MED1(deltaLiv) mice fasted for 24, 48 and 72 hours. Histological changes in liver sections from MED1(deltaLiv) mice after 72 hours of fasting were also examined using H&E staining. There was no fat accumulation in livers of MED1(deltaLiv) mice compared to MED1(fl/fl) and PPARalpha -/- control mice after 72 hours of fasting. Compared with MEDl(fl/fl) mice, plasma triglycerides in MED1(deltaLiv) mice were significantly increased after 24, 48 and 72 hours of fasting, and plasma cholesterol was significantly increased after 48 and 72 hours of fasting. Lipoprotein profiles were similar in fed MED1(fl/fl) and MED1(deltaLiv) mice. However, very low density lipoprotein (VLDL) was significantly increased in MED1(deltaLiv) mice after 24 hours of fasting. We conclude that, hyperlipidemia in MED1(deltaLiv) mice in response to fasting is due to the accumulation of VLDL, which suggests that MED1 plays a pivotal role in the regulation of plasma triglyceride and cholesterol levels.
Animals ; Cholesterol ; blood ; Fasting ; Hyperlipidemias ; blood ; Lipoproteins, VLDL ; blood ; Liver ; chemistry ; Mediator Complex Subunit 1 ; genetics ; physiology ; Mice ; Mice, Knockout ; Triglycerides ; blood

Objective: To evaluate the effect of the Thyroid Imaging Report and Data System proposed by American Radiological Society (ACR-TIRADS) for differential diagnosis in thyroid nodules, and compare ACR-TIRADS to the TIRADS proposed by Kwak et al.(K-TIRADS) and the ultrasound-based risk stratification system evaluated by American Thyroid Association (ATA-Risk Stratification). Methods: The clinical data of 1 760 patients with 1 912 thyroid nodules from 8 hospitals in Jiangsu province were retrospectively analysed. All of them were categorized based on ultrasound-based risk stratification systems. The ROC curve was established to assess and compare the diagnostic value of the systems. Results: The area under the ROC curve (AUC) of ACR-TIRADS was 0.830, with high sensitivity and negative predictive value (86.9% and 87.5%, respectively), and relatively low specificity and positive predictive value (64.1% and 62.9%, respectively). The sensitivity and specificity of K-TIRADS were up to 84.9% and 76.1%, respectively. The AUC of ATA-Risk Stratification was 0.852, with relatively high specificity (83.4%), and low sensitivity (79.4%). There were significant differences in the AUC among the three ultrasound-based risk stratification systems, of which K-TIRADS was the highest (P<0.001). There was no significant difference in sensitivity of ACR-TIRADS and K-TIRADS (P=0.137), but significantly higher than that of ATA-Risk Stratification (P<0.001). There were significant differences in the specificity among the three systems, of which ATA-Risk Stratification was the highest (P<0.001). In addition, there were 109 nodules (5.7%) couldn′t be classified based on ATA-Risk Stratification, with high malignancy rate of 31.2%. Conclusions The diagnostic efficiency of ACR-TIRADS is good, but lower than K-TIRADS and ATA-Risk Stratification. ACR-TIRADS has the highest sensitivity, and ATA-Risk Stratification has the highest specificity, while the overall diagnostic efficiency of K-TIRADS is the best.

ObjectiveIn order to find a fast odor-based method for the identification of sulfur fumigated Gastrodiae Rhizoma， an ultra-fast gas phase electronic nose technology was used to identify the odors of different degrees of sulfur fumigated Gastrodiae Rhizoma decoction pieces. MethodHeracles NEO ultra-fast gas phase electronic nose was employed to collect gas chromatograms of unsulfured and sulfured with different degrees of Gastrodiae Rhizoma decoction pieces， gas chromatograms were performed under programmed temperature （initial temperature of 40 ℃， 0.2 ℃·s^-1 to 60 ℃， and then 4 ℃·s^-1 to 250 ℃）， the sample volume was 5 mL， the incubation temperature was 65 ℃ and incubation time was 35 min. Kovats retention index and the AroChemBase database were used for qualitative analysis， and stoichiometric analysis was performed on this basis. Principal component analysis （PCA）， discriminant factor analysis （DFA） and partial least squares-discriminant analysis （PLS-DA） models were established to identify the Gastrodiae Rhizoma decoction pieces with different degrees of sulfur fumigation. ResultAccording to the comparative analysis of AroChemBase database， there were significant differences in the odor characteristics of sulfur fumigated and non-sulfur fumigated Gastrodiae Rhizoma， cyclopentane， acetone and heptane might be the odor components to distinguish the degree of sulfur fumigation in Gastrodiae Rhizoma decoction pieces. The identification index of PCA model was 81， the accumulative discriminant index of the discriminating factors was 92.09% in DFA model， the supervisory model interpretation rate of PLS-DA model was 0.963 and the predictive ability parameter was 0.956， indicating that PCA， DFA and PLS-DA models could well distinguish Gastrodiae Rhizoma decoction pieces with different sulfur fumigation degrees. ConclusionHeracles NEO ultra-fast gas phase electronic nose can be used as a rapid method to identify and distinguish Gastrodiae Rhizoma decoction pieces with different levels of sulfur fumigation. Meanwhile， it can provide a rapid， simple and green method and technology for identification of traditional Chinese medicine decoction pieces by sulfur fumigation.

OBJECTIVETo investigate the effects of PPARγ overexpression on steatosis in mouse primary hepatocytes.

METHODSPrimary hepatocytes isolated from C57BL/6J mice were infected with either Ad/LacZ or Ad/PPARγ for 48 h. Steatosis of the primary hepatocytes was checked by Oil Red O staining. The mRNA and protein expression of adipocyte-specific genes PPARγ, aP2 and CideA were analyzed by using RT Real-time PCR and Western Blot.

RESULTSPrimary hepatocytes were small and even. Hepatocyte nuclei were round with dispersed chromatin and prominent nucleoli. Accumulated lipid droplets were observed in Ad/PPARγ-infected hepatocytes, but in Ad/LacZ-infected hepatocytes. Moreover, compared with Ad/LacZ-infected hepatocytes, the mRNA expression of PPARγ, aP2, FGF21 and CideA in Ad/PPARγ-infected hepatocytes were significantly induced, the protein expression of PPARγ and its target aP2 strongly increased.

CONCLUSIONover expression of PPARγ induces adipogenic steatosis in mouse primary hepatocytes.

Adipocytes ; metabolism ; Adipogenesis ; Animals ; Cells, Cultured ; Fatty Liver ; metabolism ; pathology ; Genetic Vectors ; Hepatocytes ; metabolism ; pathology ; Mice ; Mice, Inbred C57BL ; PPAR gamma ; metabolism ; Transfection